This
study is designed to determine whether parent training is an
effective means of increasing children's consumption of a
high calcium diet and increase their strength and aerobic
exercise in order to prevent osteoporosis as adults.
Children (N=180) will be recruited sequentially. Males and
females from different racial /ethnic backgrounds will be
included. One child/family will serve as the unit of random
assignment. A 2 x 2 x 4 random assignment, repeated measures
design will be employed. Children and their parents will be
divided into two groups. The experimental group will receive
educational and support services for diet and exercise
change in the target child (N=90). The control group will
obtain similar training for child safety (N=90). Each of
these conditions will be divided again at random into two
subgroups: one (N=45) will obtain parent training concerning
the target topic (i.e. safety or diet and exercise); the
second (N=45) will obtain the same instruction plus episodic
coaching. Training will require 9 weekly classes and will
emphasize principles of behavior and contingency management
techniques. Coaching procedures will be provided over 9
months and will assist parents with problem solving in order
to refine and maintain parenting skills. Measures will be
obtained 4 times, prior to parent training, at the end of
parent training (3-months) and repeatedly through out the
coaching period. Outcome measures will include 24-hour
recall estimates of change in diet, and change in physical
activity. These will be validated by objective outcome
measures, including 1RM strength and VO2 max fitness
measures. Using the state of the art DXA scans, total bone
calcium, bone density and specific bone density will be
obtained. Body composition will be assessed by DXA.
Generalized estimating equations will be employed to
estimate main effects, covariates, and interactions to test
study hypotheses. Exploratory analyses will include
assessment of hypothetical processes, such as parenting
practices and child/parent interactions and mediating
variables in achieving eating and exercise changes; in
achieving changes in bone density. Results will inform
clinical and educational procedures for prevention of
osteoporosis in males and females from different racial
ethnic backgrounds at risk for osteoporosis.